Bone Scan

A Patient's Guide to Bone Scans

What it is: A bone scan can be used to locate a problem area of the
spine. It is a test where a radioactive chemical is injected into the bloodstream
and pictures are taken a short time later. The chemical very quickly attaches
itself to areas of the skeleton that are busy making new bone. In an adult,
this usually means there is a problem in the area and the increased bone making
activity is a response by the skeleton to a problem in the area.

For example, if there is a fracture of the bone, the bone cells will very quickly
begin to make new bone to try to repair the fracture. The injected chemical
begins to concentrate in this area several hours after the injection. A special
camera takes pictures of the area of the skeleton where the problem is. Problem
areas will show up as dark areas on the film, because more of the chemical has
concentrated in that area. Since the chemical tracer is radioactive, it sends
out radiation that can be captured by a special camera. The camera is similar
to a "Geiger counter" in that it uses film to capture the radioactivity. The
radioactivity shows up as a hotspot on the film.

What the test shows: A bone scan is very useful when it is unclear exactly
where the problem is in the skeleton. It offers the ability to take a picture
of the entire skeleton and light up the area where the problem seems to be coming
from. This gives the doctor the advantage of pinpointing exactly where to look
next. After locating the problem areas, other tests will be done to show more
aspects of those specific spots. The bone scan can show problem areas such as
bone tumors, infection, and fractures of the spine. A bone scan can also be
used to determine bone density and the bone-thinning condition of osteoporosis.

What the test does not show: The bone scan does not show the details
of the bones or soft tissue. It only shows how much the bone around a specific
area is reacting to the problem.

How the test is done: The bone scan works by injecting a radioactive
chemical, sometimes called a "tracer", into the bloodstream through an intravenous
line (IV). The chemical will attach itself to any areas of bone that are undergoing
rapid changes. The test requires that an IV be started in your hand or arm.
The chemical is then injected and you wait for several hours. Usually you are
free to leave and come back in two to three hours. You will then be asked to
lie or sit underneath a large "camera" that will take pictures of the skeleton.
This may take 30 - 90 minutes.

What risks the test has: The test uses a dye that must be injected.
There is always the risk of an allergic reaction to anything injected into the
bloodstream. In this case, an allergic reaction is uncommon. The dye that is
injected is a radioactive substance, however, it disappears from the body very
rapidly (within hours).

What the test costs: A bone scan of the spine usually has two costs
associated with it. The first cost is the fee for actually doing the test. This
is called the "technical fee". The second cost is the fee of having a specialist,
such as a radiologist, read and interpret the test. This is called the "professional
fee". You may get two bills for this test: one from the hospital or clinic where
you had the bone scan done, and one from the specialist who read the test.